Discount Tire 2016 NE Benefits Guide - Inside Pages - BCBS

Transcription

2016
BENEFITS GUIDE
BENEFITS GUIDE
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Healthy Thinking Healthy Action Healthy You
D E A R V A L U E D E M P LO Y E E S ,
TA B L E O F C O N T E N T S
When it comes to your employee benefits, our
goal is to give you choices to help you make
informed decisions.
Important to Note
2
Q&A: Affordable Care Act
3
Eligibility
4
Medical Plan Choices
5
Medical Plans Compared
6
Health Savings Plan with the HSA
8
Dental Plan
10
Vision Plan
11
Flexible Spending Accounts (FSA)
12
Health & Wellness Features
13
Healthy Action
Life and Disability Insurance
14
Employee Assistance Program (EAP)
15
After you have reviewed this guide, log in to
Workday to select the options that best fit you and
your family’s needs.
401(k) Retirement Plan
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Discount Tire / America’s Tire / Discount Tire Direct
(the Company) is offering a new medical plan
option, the Health Savings Plan, which includes a
Health Savings Account (HSA). This plan allows you
to take a more active role in how you spend—and
save—your health care dollars. (See page 8 for
more details.)
Healthy Thinking
Healthy You
As always, we care for you! The Company pays a
large share of our employee benefits to keep the
costs affordable for you.
2 016 BENEFITS GUIDE
Review this guide and consider the benefit choices
the Company provides to you.
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The Company remains
dedicated to providing
cost-effective benefit
options. Each year, all
benefits are reviewed
to ensure the best
choices for coverage
are available for you
and your family.
Enrollment Checklist
After you’ve reviewed this guide and are ready to enroll in your benefits, log in to
Workday at http://myworkday.com/tires. If you need help logging in or need
detailed instructions, see the Workday Full Time ESS Benefits Enrollment Quick
Reference Guide located in the front of this packet.
Once you’ve logged in to Workday, you’ll have the following options:

Declare you are tobacco free or in a tobacco cessation program to
qualify for the 2016 Wellness Rate
Enroll in benefits for you and your dependent(s)
Set the weekly contribution to your Health Savings Account (if you
enroll in the Health Savings Plan)
Participate in WageWorks’ Health Care and/or Dependent Care
Flexible Spending Accounts for 2016

Apply for Basic, Additional, Spouse and/or Child Life Insurance

Apply for Short Term Disability and/or Long Term Disability

Add your beneficiary information
Log into Workday at: http://myworkday.com/tires
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Healthy Thinking:
QUESTIONS AND ANSWERS ABOUT THE AFFORDABLE C ARE AC T (AC A)
Q: Am I required to have health
insurance?
A: Yes. As of January 1, 2014,
you and each member
of your family must have
health insurance that
qualifies as minimum
essential coverage according
to the requirements of the
Affordable Care Act (ACA).
Q: What happens if I don’t
have health insurance?
A: If you don’t have
minimum essential health
coverage, you may be
subject to a tax penalty.
The Company’s medical
plan options meet the
minimum essential
coverage requirements.
Q: How much are the tax
penalties for 2016?
A: For individuals, the tax penalty
for not having minimum
essential coverage is $695
or 2.5% of your annual
income, whichever is greater.
For families, the penalty is
$2,085 or 2.5% of your annual
income, whichever is greater.
More questions about your health care rights and responsibilities? Visit www.healthcare.gov.
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ELIGIBILITY
Who is Eligible to Enroll for Benefits?
Employees:
Full-time employees are eligible for the Company’s benefit plans after 90 days of full-time employment. The 401(k) plan is open to
employees age 21 and over, after completing 1,000 hours of service.
Dependents:
Eligible dependents include your legal spouse and children up to age 26.
The definition of “child” includes any of the following:

Your child / stepchild

A child placed with you for adoption

Your legally adopted child

A child for whom you have legal guardianship

Your child for whom health coverage is required through a
Qualified Medical Child Support Order (QMCSO)
I N F O R M AT I O N A B O U T M A K I N G M I D - Y E A R C H A N G E S :
Please enroll your covered dependents in Medical, Dental, and Vision if needed. This is the only time you may do so this
year, unless a qualifying life event occurs as described below. Documentation is required if adding dependent(s).
The only other time you may make a change in your coverage during the year is if you have a qualifying life event in your family or
employment status. Enrollees may change from one coverage type to another with one of the qualifying life events listed below,
as long as the election is made for the change in coverage within 31 days of the qualifying life event (or 60 days in the event of
Children’s Health Insurance Program). Changes will be effective on the date of the qualifying event.
Below is an outline of Qualifying Life Events and the documentation needed to make a change to your benefit plan(s).
Qualifying Life Event
A change in marital status:
Marriage
Divorce
Death of Spouse
A change in the number of your dependents:
Birth or adoption
Death of a dependent
Dependent(s) obtain their
own coverage
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Documentation Required

Marriage Certificate
Divorce Decree
Death Certificate
Birth Certificate/Adoption Agreement
Death Certificate
Proof of other coverage and
effective date
Termination or commencement of
employment by employee, spouse,
or dependent
Documentation from the employer
confirming prior coverage and effective date
Any significant change in your family’s
health care plan coverage through your
spouse’s health care plan
Documentation from spouse’s employer
confirming change in coverage and effective
date of change
Change in a dependent’s eligibility status
(i.e. a dependent child exceeding the
maximum age for coverage)
Proof of the event (i.e. proof of child’s date
of birth)
Once a qualifying life event
occurs, you have 31 days
from the date of the event
to log in to Workday to submit
the changes to your benefit
elections and upload supporting
documents (i.e. birth certificate,
marriage certificate, etc.).
If you do not submit your
changes within 31 days, you
may not be eligible to change
your benefit elections until the
next open enrollment.
MEDICAL PLAN CHOICES:
BLUE CROSS BLUE SHIELD OF ARIZONA (BCBS)
Selecting the right medical plan takes careful consideration. The
Company offers medical plan options through Blue Cross Blue Shield of
Arizona; choose the plan which best meets your needs. You can manage
all aspects of your medical plan from www.mybenefitshome.com.
PPO Blue Plan

Coverage through the PPO Blue Plan is a more traditional health care
option with a deductible, set co-pays and coinsurance amounts.
With the PPO Blue Plan, you have the option to elect the Flexible
Spending Account (FSA). See details on page 12.
Prescription costs are not counted towards the annual deductible;
co-pays apply.
Health Savings Plan

The Health Savings Plan is a medical plan with a Health Savings Account (HSA).
The Company contributes to your HSA: $500 for individual / $1,000 for family.
Plus, you can contribute to your HSA tax free. See details on page 8.
Use your HSA money to pay your out of pocket health care expenses, including
your deductible and prescription drug expenses. All prescription costs are
applied to your deductible; after you meet the deductible, the plan covers
90% with 10% employee coinsurance.
With the Health Savings Plan, you have the option to elect the Flexible Spending
Account (FSA), but you may only use FSA funds to pay for dental and vision
expenses. You cannot use FSA funds to pay for medical expenses.
Your HSA goes where you go! Even if you change jobs, switch health plans, or
retire, your HSA is yours—you own it, and the money carries over from year to
year. See details on page 8.
Healthy Action: ANNUAL WELL VISIT
Have your Physician complete the Physician
Affidavit, add your signature and return it to
Human Resources by December 31, 2016:
• You and your spouse are eligible
• Receive a $50 gift card each
Find the form in the front of this packet or on
the Knowledge Center. Email completed forms
to benefits@discounttire.com.
PREVENTIVE CARE
AT N O C O S T:
With all plan options, in-network
preventive care is fully covered
with no cost sharing, including
well child, routine physicals,
OB/GYN exams, mammograms
and prostate exams.

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M E D I C A L P L A N S C O M PA R E D
Benefit
PPO Blue Plan
In-Network
Health Savings Plan
Out-of-Network ∆
Out-of-Network ∆
In-Network
The Company’s Contribution
Individual/Family
$500/$1,000 ∑
(Does not apply)
Annual Deductible
$500/$1,500
$1,000/$3,000
$2,000/$4,000 Ω
$4,000/$8,000 Ω
$2,500/$6,500
$7,000/$18,000
$3,500/$6,850
$7,000/$14,000
Unlimited
Unlimited
Unlimited
Unlimited
Physician
$20/visit
70%
90%*
70%
Specialist
$40/visit
70%
90%*
70%
100%
70%
100%
70%
$40
70%
90%*
70%
90%*
70%
90%*
70%
Individual/Family
Maximums
Out-of-Pocket: Individual/Family
Lifetime Maximum
Office Visits
Preventive Care
Routine physicals, immunizations, pap smear,
mammogram, prostate screening, etc. Frequency
limitations apply.
Maternity Care
Prenatal Visit
Postnatal Visits/Surgery
Care
Urgent Care
$40/visit
90%
90%*
90%
Emergency Room
$200
$200
90%*
90%
Hospital Care
90%*
70%
90%*
70%
Outpatient Surgery
90%*
70%
90%*
70%
Retail
(30 day supply)
Mail Order
(90 day supply)
Retail
(30 day supply)
Mail Order
(90 day supply)
Tier 1
$10
$20
90%*
90%*
Tier 2
$30
$60
90%*
90%*
Tier 3
$60
$120
90%*
90%*
Tier 4
$90
$180
90%*
90%*
Prescription Drugs
Retail Pharmacy/Mail Order
* = After deductible
∑ = Refer to the Company Funding Schedule on page 8.
Ω = The Health Savings Plan also requires that the FULL family deductible (e.g. $4,000 for in-network) be met if you have enrolled
any dependents at all.
∆ = When you receive out-of-network care, the plan covers its percentage up to the Reasonable and Customary (R&C) limit, after
you satisfy the Annual Deductible. You pay the remaining percentage up to the R&C limit plus any amount above the R&C limit.
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Healthy Action: WELLNESS RATE—Save on 2016 Medical Benefits!
Are you tobacco free? Don’t miss out on the Company’s Wellness Rate on your 2016 medical plan contributions. Employees
who declare they are tobacco free or are enrolled in a tobacco cessation program are eligible. Your Tobacco Free Affidavit
is completed in Workday as part of your benefit enrollment elections. To participate, just follow the instructions in
Workday as you make your 2016 benefit elections. Please note: you have to declare you are tobacco free every year to
qualify for Wellness Rates, even if you are not changing your benefit elections from year to year.
Healthy Thinking: MAIL-ORDER PHARMACY
Do you have prescription medications that you take
regularly? If so, you could save by filling your prescriptions
with the Medco Mail-Order Pharmacy.
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Maximum convenience and peace of mind
24/7 access to pharmacists
Lower out-of-pocket costs
Standard shipping at no cost to you

Call 1-800-903-6228.

Your physician can call 1-888-327-9791 for
instructions to fax prescription(s). (NOTE:
Faxed prescriptions can only be accepted
from your physician’s office.)

Log on to www.mybenefitshome.com and
click “Prescription Services.”

By Mail: Go to www.mybenefitshome.com,
to obtain order forms and envelopes, then
mail the prescription and order form to the
address provided.
It’s easy to get started with mail order prescriptions.
Request a prescription from your doctor for a three-month
supply, with refills for up to one year (if appropriate), then
contact Medco:
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H E A LT H S AV I N G S P L A N W I T H T H E H E A LT H S AV I N G S A C C O U N T ( H S A )
An HSA can fit your unique health care needs and financial goals:
For today:
Use it for health expenses
For tomorrow:
Build a safety net
For the future:
Prepare for retirement
You and the Company contribute to
your HSA and as you have doctor’s visits,
prescriptions, and other health care costs,
you can use your HSA to pay for those
qualified expenses — tax-free.
Even if you don’t use health care often,
save money in your HSA to prepare for
expected and unexpected expenses.
You’ll rest easy knowing the money is
there when you need it.
The average retired couple today will
need about $250,000 for healthcare
expenses! Prepare for those expenses
by investing the money in your HSA and
growing your balance for retirement.
To be eligible to contribute to the HSA, you cannot have other non-HSA compatible coverage (i.e. Traditional PPO, HMO, or HRA
plans, including non-HSA compatible coverage through a spouse’s employer, your spouse enrolled in a non-limited FSA, Medicare,
or Medicaid), or have someone claim you as a dependent for tax purposes. If this is the case, you can still elect the Health
Savings Plan for the lower premium contribution, but you may not receive the employer contributions or make your own pre-tax
contributions to the HSA. If you are also enrolling in the Flexible Spending Account, you are limited to using your FSA only for
vision and dental expenses for you and your family.
How the Deductible Works
How your deductible works is based on your level of coverage:

If covering just yourself, you must meet the single deductible ($2,000 for in-network) before the plan begins paying expenses.

If covering yourself and your dependent(s), you must meet the full family deductible ($4,000 for in-network) before the plan
begins paying expenses. The expenses of everyone covered by the plan can be added together to meet the family deductible.
Once the plan begins paying expenses and you share the cost, the maximum out-of-pocket expense of any family member
will not exceed the individual maximum of $3,500.
Your Health Savings Account and Company Contributions
If you choose to enroll in the Health Savings Plan, you will receive a welcome kit and debit card from Wells Fargo to pay for
any out-of-pocket expenses. The Company will contribute $500 for individual coverage and $1,000 for family coverage per the
Company funding schedule below.
HSA: Company Funding Schedule
Benefit Effective Date
Deposit Date
Individual
Family
Jan. 1–June 30, 2016
Jan. 1, 2016
$250
$500
July 1–Sept. 30, 2016
July 1, 2016
$125
$250
Oct. 1–Dec. 31, 2016
Oct. 1, 2016
$125
$250
$500
$1,000
2016 Total:

Employees who enroll in this plan in the middle of 2016 will have their initial
HSA funding from the Company based on their benefit effective date in the
amount from the above table. (For example, if an employee enrolls their family
effective July 10, their initial HSA funding from the Company will be $250 and
then follow the schedule for the remainder of the year.)

If you change your Health Savings Plan enrollment from individual to family
or family to individual based on a qualifying event in the middle of 2016, the
Company’s contributions will remain at the plan coverage level at which you
initially enrolled.
Your Pretax Contributions to Your HSA
In addition to the deposits that the Company makes, you are able to contribute
money on a pretax basis from your paycheck to your HSA up to the combined annual
IRS limit of $3,350 for individual coverage and $6,750 for family coverage. Set your
contribution amounts in Workday. (These limits include the Company’s contribution
of $500 for individual and $1,000 for family.) If you are age 55 or older, you may
contribute up to an additional $1,000 per year to help you catch up for retirement.
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Take full advantage of the Health Savings Plan’s lower
premiums and contribute the money you save on premiums
into your Health Savings Account! Your HSA is a tax-free
savings account that you own and the money carries over
from year to year.
Use your HSA to pay for visits to your physician or when you
pick up a prescription. See other qualified expenses at
wellsfargo.com/hsaqualifiedexpenses.

If you don’t use your benefits, use your HSA to save for
unexpected medical expenses or invest the money in your
HSA to help prepare for retirement.

Watch the videos to help you understand your choices on
how to use your HSA at wellsfargo.com/hsaresources.
Healthy Thinking:
IS AN HSA FOR YOU?
Health Savings Accounts have a triple tax
advantage:
•
money goes in pre-tax
•
it grows tax free
•
it can be withdrawn tax free
Nearly 80% of plan members spent $2,000
or less in medical expenses in 2015. If you
are in that group, the Health Savings Plan
and the financial advantages of an HSA may
be your best choice.
Consideration Points: Which Plan Might Be The Best Fit?
Using your Health Savings Account
How much did you spend on
copays, deductibles, coinsurance,
and prescriptions last year?
Review your 2015 claim information. See if your health care expenses were what you planned
for or if there were unexpected costs. Then, think about how much you expect your costs to be
in 2016. Use that determination to review the plans and choose which option will cost you less.
Do you have a surgery scheduled
next year? Are you pregnant?
If you have plans for a non-routine year, speak to your physician about how much these services
may cost. After you have a general idea of those costs, you will be able to review your plan
options to choose a plan that will cost you the least over the year.
Do you have a clear understanding
of how the coinsurance prescription drug program works?
If you have ongoing prescriptions, you need to have a clear understanding of what the drugs
cost (retail, without insurance) and if it is a generic, formulary, or non-formulary prescription. For
instance, if your required drug is formulary and is fairly expensive, you should consider the PPO
Blue Plan, as it has set co-pays. With the Health Savings Plan, you would be responsible for the
full cost of the drug until you meet the deductible.
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D E N TA L P L A N : D E LTA D E N TA L
Delta Dental of Illinois provides you access to a national network of preferred
providers. Although you are not required to use these providers, benefits are
enhanced when selecting providers within the preferred network. Find preferred
providers at www.deltadentalil.com or download the Delta Dental mobile app.
Benefit
PPO Network
Plan Pays
Premier Network
Plan Pays
Out-of-Network
Plan Pays
$50/$150
$50/$150
$50/$150
Annual Deductible
Individual/Family
Maximum Benefits
Annual Max Per Individual
Lifetime Maximum
$1,750
$1,750
$1,750
Unlimited
Unlimited
Unlimited
100%* of
reduced fee
100% ∑ of
MPA
100% Ω of
MPA
80%* of
reduced fee
80% ∑ of
reduced fee
80% Ω of
reduced fee
50%* of
reduced fee
50% ∑ of
reduced fee
50% Ω of
reduced fee
50% of
reduced fee
50% of
dentist’s fee
50% of
dentist’s fee
$2,000
$2,000
$2,000
Preventive Services Include:
Oral Evaluations, X-Rays and
Cleanings (2 cleanings/year)
Basic Services Include:
Fillings, Extractions,
Endodontics
Major Services Include:
Implants, Inlays, Onlays,
Crowns, Bridges and
Prosthodontics
Orthodontia
Coverage Level
Lifetime Maximum
* = You will not be “balance billed” for charges exceeding Delta Dental’s allowed PPO fees.
∑ = You will not be “balance billed” for charges exceeding Delta Dental’s maximum plan allowances (MPAs)
Ω = You are responsible for charges exceeding Delta Dental’s maximum plan allowances (MPAs)
Healthy Action:
Delta Dental’s Free Mobile App
with Dental Care Cost Estimator
Find a dentist, review your claims
and coverage details, and view
or share your ID card all from the
Delta Dental mobile app.
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VISION PLAN: SUPERIOR VISION
Through Superior Vision, you can choose from a large number of in-network
providers that will help you save money. Find an in-network provider, or confirm
your current provider is in the network at www.superiorvision.com. The vision plan
is a voluntary benefit, 100% employee paid.
In-Network
Plan Pays
Out-of-Network
Reimbursement
100%
$34
Single Vision
100%
$29
Bifocal
100%
$43
Trifocal
100%
$53
$150 allowance
$75 allowance
Benefit
Exams (once every 12 months):
Exams/Screenings
Lenses (once every 12 months):
Frames (once every 12 months):
Retail Chain Provider
Contacts - in lieu of eyeglasses (once every 12 months):
Elective
$150 allowance
$100 allowance
HSA and FSA dollars can be used for
Dental and Vision services.
Healthy Thinking:
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H E A LT H A N D D E P E N D E N T C A R E
FLEXIBLE SPENDING ACCOUNTS (FSA)
You must enroll in Health & Dependent
Care Flexible Spending Accounts each year.
Log in to Workday to sign up.
The Company’s Flexible Spending Accounts (FSA) can help you
save money. By paying for eligible health care and dependent
care expenses for you or your qualified dependent(s) with an
FSA, you reduce your taxable income and pay no federal, state
or social security taxes on the money used for those expenses.
You must enroll each year to participate. FSA plans contain
a “Use It Or Lose It” provision—please plan carefully! Benefits
terminate when you leave the Company.
FSA plans contain a “Use It Or Lose It”
provision—please plan carefully!
If you are enrolled in the HSA, you cannot
use your FSA dollars for anything other
than dental and vision expenses.
Health Care Flexible Spending Account
Use your Health Care FSA to pay for eligible medical, pharmacy, dental and vision expenses for you and your dependents. This
includes but is not limited to, the cost of co-pays, coinsurance, eye glasses, orthodontia, chiropractic care, and eligible over-thecounter drugs. For plan year 2016, the maximum amount you can contribute to your Flexible Spending Account is $2,550. For a
list of eligible expenses, visit www.wageworks.com.
Estimate your expenses today using the tools available at
www.wageworks.com or see the example provided below.
Employee Tax Savings Illustration
Without FSA
Accounts
With FSA
Accounts
Weekly Earnings
$800.00
$800.00
Account Deposit
(Before Taxes)
$0
$20 Medical +
$100 Daycare
Taxable Wages
$800.00
$680.00
Taxes:
Federal 15%,
FICA 7.65%,
State 5%
$221.20
$188.02
Expense (After tax)
$120.00
$0
Net Take Home Pay
$458.80
$491.98
Weekly Savings
$33.18
Annual Savings
$1,725.36
Dependent Care Flexible Spending Account
Use your Dependent Care FSA to pay for eligible child care (up
to age 13) and elder care expenses that you incur because you
and your spouse work.
By law, the maximum amount that you may contribute to any
Dependent Care Flexible Spending Account for your family
is $5,000 (or $2,500 if you are married and filing a separate
return each calendar year). In addition, your provider of care
must furnish you with either his/her Social Security Number or
Tax Identification Number. For a list of eligible expenses, visit
www.wageworks.com.
Flexible Spending Account Management
Managing your account is easy. With a variety of payment and
reimbursement options, your WageWorks FSA is easy to use. For
Health Care FSAs, you’ll be provided with a convenient WageWorks
Healthcare Card that will give you swipe-and-go convenience. You
also have the option to submit your receipts using the WageWorks
EZ Receipts mobile app.
Access your FSA account online at www.wageworks.com, to
submit claims, check your balance and access forms. You can also:
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View claim status

Add a dependent

View claim history

Sign up for electronic notifications
H E A LT H & W E L L N E S S F E AT U R E S
By taking better care of ourselves, we have the opportunity
to live healthier lives as well as reduce future medical costs.
A variety of health and wellness features are available to
you for free at www.mybenefitshome.com as part of our
comprehensive medical benefit plan through Blue Cross Blue
Shield Of Arizona (BCBS).
Blues On Call
Health Coaching
Blues On Call is a comprehensive health information and
support program offering a wide variety of up-to-date, easy to
understand health care resources. You will be connected to a
Health Coach, who is a specially trained registered nurse. Your
Health Coach can help you with:
BCBS’s online coaching programs are designed to guide
you down a path of personalized health and well-being.
Customized for you, the interactive online coaching provides
you with support every step of the way including:

Managing chronic conditions

Making health decisions

Serving as a support resource
W E E K LY
TO-DO
LISTS
TOOLS &
TRACKERS
MEAL
PLANS
MESSAGING
TO KEEP YOU
M O T I V AT E D
Contact Blues On Call at 1-888-BLUE-428 (1-888-258-3428)

You are encouraged to take the Wellness Profile every year
to track your progress.

Log onto www.mybenefitshome.com to create your
Wellness Profile today.
Preventive Services

Routine Physical Examinations

Immunizations

Well-Baby and Well-Child care

Well-Woman Care and PAP tests

PSA Screening
Baby Blueprints

Colonoscopy
Baby Blueprints Maternity Education and Support is a free
program to BCBS members that helps expectant mothers at
each stage of pregnancy. Once enrolled in Baby Blueprints,
you’ll have access to in-depth educational information on all
aspects of pregnancy through multiple online offerings, and
individualized support throughout your pregnancy from a
nurse Health Coach. Call 1-866-918-5267 for more information
and to enroll.

Mammograms

Hearing Screenings
Our benefit plans offer preventive services paid at 100% when
an In-Network provider is used. We encourage you and your
family to visit your doctor to get the preventive screenings
needed to keep you healthy.
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LIFE AND DISABILIT Y INSURANCE: LINCOLN FINANCIAL GROUP
Basic Life Insurance and AD&D
The Basic Life Insurance benefits through the Company offer you a way to protect your
family’s financial security in case of injury or death. The cost is $.89 per week and the
benefit is 1.5x your annual salary, up to maximum of $50,000.
Additional and Dependent Life Insurance
Healthy Thinking:
WHY DO I NEED A BENEFICIARY?
Your beneficiary is the person(s) or
entity(ies) who receive(s) the cash
benefit from your policy when
you die. If you don’t choose one,
your state’s laws determine who
receives the proceeds. You can
change your beneficiaries at any
time by logging into Workday.
The Company offers employees the flexibility to purchase Additional Life Insurance in
$10,000 rounded-up increments up to 7x your base salary, capped at $500,000. If you
elect additional life coverage for yourself, you may purchase Dependent Life Insurance
for your spouse and child(ren). The Spouse Life benefit may be elected in $5,000
increments up to 50% of your additional life benefit election, capped at $100,000. The
Child(ren) Life benefit covers all of your children in the amount of $5,000 (for a $.10 per
week payroll deduction) or $10,000 (for $.20 per week). The benefit amount reduces at age 65 and benefits terminate when you
leave the Company.
Short Term Disability Insurance
This benefit is designed to replace 60%
of your income, up to a maximum of
$1,200 per week, if you are unable to
work due to a non-work related short
term illness or injury. This benefit
pays for up to 24 weeks. The cost for
this benefit is based on your annual
earnings. Short Term maximum
earnings are $104,000.
Long Term Disability Insurance
This plan provides 60% of your income, up to a maximum of $6,000 per month, beginning after 180 days of continuous disability.
The cost for this benefit is based on your annual earnings and age.
Disability Insurance Summary Table
Short Term Disability Plan
Benefits Begin
15th day of absence from work due to an illness/injury
After 180 days of disability
Up to 24 weeks (after waiting period)
As determined by the Plan
What You Will Receive
60% of basic weekly earnings*
60% of monthly earnings*
Up to a Maximum of
$1,200/week
$6,000/month
Duration of Benefits
*Earnings are defined based on your employment class. Pre-existing condition limitation may apply.
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Long Term Disability Plan
E M P LO Y E E A S S I S TA N C E P R O G R A M ( E A P )
What is the EAP?
The Employee Assistance Program (EAP) is a confidential, FREE resource available to you
for help with personal issues which might be affecting you and/or your dependents.
Some of the reasons you might use an EAP include:

Personal/family issues

Relationship issues (at work or home)

Work concerns/work-related stress

Legal issues

Financial concerns

Childcare referrals

Substance abuse

Elder care referrals
How Does the Program Work?
When you call the EAP, a counselor will spend time with you or your family member on the phone to identify the issue, gather
information and provide personal assistance. When appropriate, the EAP counselor will help schedule an appointment with an
EAP affiliate for a face-to-face meeting. All of the EAP counselors and affiliates are licensed by state governing agencies. Up to 6
sessions are provided free of charge to each employee or family member per issue.
EmployeeConnect Plus
Our EAP is provided through EmployeeConnect Plus and administered by ComPsych. EmployeeConnect Plus can be reached at
855-327-4463 or register online at www.GuidanceResources.com. (When registering, the Organization Web ID is Lincoln).
4 01 ( K ) R E T I R E M E N T P L A N
Empower Retirement
Empower Retirement is the record keeper for the Company’s 401(k) plan. Employees age 21 or
older are automatically enrolled in the 401(k) plan after completing 1,000 hours of service.
Contribution Matching
If your weekly
deferral is:
Your annual contribution
would be*:
The annual Company
match would be:
Total annual account
contribution would be:
3%
$1,200
$1,200
$2,400
4%
$1,600
$1,400
$3,000
5%
$2,000
$1,600
$3,600
6%
$2,400
$1,800
$4,200
*Based on an annual salary of $40,000.
The default contribution percentage is 5%, but you may change it at any time. The Company’s matching contributions are
deposited in your account quarterly and you are 100% vested in the employer matching contributions after 3 years of service
(minimum of 1,000 hours each calendar year). To take full advantage of the Company match, call Empower Retirement at
800.345.2345, or manage your account online anytime via their website at www.empower-retirement.com/participant.
Roth 401(k) Feature
We now offer a Roth 401(k) feature that allows you to have retirement contributions deducted from your paycheck after you
pay taxes. To decide if Roth 401(k) contributions are right for you, log in at www.empower-retirement.com/participant for
more information, or consult with your financial professional.
The Company takes your retirement seriously and we’ve made contributing to the 401(k)
Retirement Plan a win/win benefit. We encourage you to save by matching your contributions
$1.00 for every $1.00 you contribute up to 3% of your compensation and $.50 for every $1.00
on the next 3%. By deferring 6% of your eligible compensation you maximize your match.
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